Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 000980 | GA |
Y | 2080P0203X | Pediatric Critical Care Doctor | 000980 | GA |
NPI | 1184801755 |
---|---|
Provider Name | Dr. Craig Michael Burger |
First Address | Atlanta, GA 30308-2373 |
Second Address | Atlanta, GA 30322-1060 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/01/2008 |
Last Update Date | 25/01/2008 |